Darn it! Yeah, he's still in the hospital but even so we are reassured daily that he is recovering well; that this is all pretty normal within the realm of transplants.
I will go back in this blog to detail the amazing process we have been going through later but wanted to let everyone know the latest.
Discharge originally was thought to be Friday, Jan 28 or Saturday the 29th based on how well he was doing, his being up and walking, feeling pretty doggone good, etc. He has two chest tubes which drain off any fluids that accumulate around the new lung as a result of the surgery. These tubes are attached to a sucture machine initially and then when any fluids being extracted are minimal sucture is turned off. At that point the tubes are placed on what is called a "water seal." This is where any air leaks show up in the water as bubbles. It also indicates (with no air bubbles) that the body is sealing the area by itself and it is safe to take out the tubes. We need to all agree here that I have not given the most medical description of the process, and there may be some slight errors as well. However, for the most part, you should all get the basic idea, right?
When the suction was turned off and transferred to the water seal step it became apparent that there was an air leak going on somewhere. We were reassured that this was normal, that we shouldn't immediately think something was wrong with the lung (which of course we did). Since it was now Friday the decision was made to leave him on the suction until Sunday, then switch to water seal, and if all went well the tubes would be removed on Monday and we could bring him home.
When Clay was originally diagnosed back in late 2001 we went thru this same thing. He was in and out of the hospital for over three months because each time the surgeons went into his lungs/chest for biopsies they could not get the area to seal. While we don't expect to go thru all of that again, we are certainly familiar with it.
A side effect of this air leak can sometimes develop into what is called rice krispies (not the clinical term of course). Clay had this back in 2001 and again this weekend. This is where the air that is being released inside the chest cavity moves into surrounding tissues causing swelling from the air pockets. Pressing on these areas of the chest both sound and feel like pressing on rice krispies. Quite weird. It isn't necessarity painful for the person having it, however, when it becomes extensive it puts pressure on the chest making it difficult to breath. This had just started prior to the suction being turned back on so it didn't develop far and was not putting any pressure on that gorgeous new lung. The air will dissipate by itself in the couple of days/weeks, does not require any specific treatment.
Which is why his discharge was moved back from Monday to Wednesday. Again, darn it! Also, over the weekend Clay's white blood count went up - which is an indicator of either infection or rejection. None of the tests could determine which it was or why the count went up. He wasn't developing a fever, didn't feel bad, none of the indicators of infection. Blood tests continued routinely over the weekend to see if the count went up or down or if any symptoms would develop.
Come Monday blood tests showed that the count had gone up even higher even though Clay still appears asymptomatic. The infectious disease folks have been called in to lend their decision on this, we are still awaiting that.
The rice krispies are now minimal and while the doctors say that they would take the suction off again moving to water seal they feel that given what is going on with the white cell count he might as well stay on it for another day. The earliest chance of discharge right now Thursday.
That may be more explanation that you wanted but it's where we are! Clay continues to progess although it's that stair step method. Pain remains to be only from the tubes, he gets up and walks several times a day (making about 6 loops around the floor at a time!), maintains 97 - 100% saturation level breathing room air, and is more than ready to get out the hospital and home.
Heading out to the hospital now, hopefully I will have the time and energy to start blogging again this evening and fill in the gaps from the time the phone rang and where we are today.
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